Targeted neighbourhood social policies are policies that target specific neighbourhoods of ‘deprivation’ for additional investment and support. As a community policy framework, they are both popular and controversial. This paper considers the targeted neighbourhood policy strategy in terms of its roots, rationale, assumptions, and concerns. Specifically, the paper investigates the notion of ‘neighbourhood effects’, the concern of neighbourhood stigma, and the link between targeted neighbourhood policy and neighbourhood pathologization. The paper concludes by considering the reasons why targeted neighbourhood policy continues to be enacted in the face of these ongoing concerns. This analysis is relevant to recreationists and healthy community advocates because of the range of ways that place-based approaches intersect with recreation and community health.